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Journal of Medicine and Philosophy 2008 33(5):461-497; doi:10.1093/jmp/jhn023
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© The Author 2008. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Foundational Ethics of the Health Care System: The Moral and Practical Superiority of Free Market Reforms

Robert M. Sade

Medical University of South Carolina, Charleston, South Carolina, USA

Address correspondence to: Robert M. Sade, MD, Division of Cardiothoracic Surgery, Medical University of South Carolina, PO Box 250612, 96 Jonathan Lucas Street, Suite 409, Charleston, SC 29425, USA. E-mail: sader{at}musc.edu


   Abstract

Proposed solutions to the problems of this country's health care system range along a spectrum from central planning to free market. Central planners and free market advocates provide various ethical justifications for the policies they propose. The crucial flaw in the philosophical rationale of central planning is failure to distinguish between normative and metanormative principles, which leads to mistaken understanding of the nature of rights. Natural rights, based on the principle of noninterference, provide the link between individual morality and social order. Free markets, the practical expression of natural rights, are uniquely capable of achieving the goals that central planners seek but find beyond their grasp. The history of this country's health care system and the experiences of other nations provide evidence of the superiority of free markets in reaching for the goals of universal access, control of costs, and sustaining the quality of health care.

Keywords: bioethics, central planning, free markets, health care reform, health care system


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